INTRADUCTAL PAPILLARY-MUCINOUS TUMORS OF THE PANCREAS - CLINICAL AND MORPHOLOGICAL FINDINGS IN 30 PATIENTS

Aim. - Intraductal papillary-mucinous tumors of the pancreas are rare and characterized by a malignant potential. The aim of this study was to clarify their clinical presentation and the performance of differen t imaging procedures to determine malignancy and tumor extent. Methods . - Medical records and radiographs of 30 patients with histologically confirmed intraductal papillary-mucinous tremor of the pancreas were reviewed retrospectively. Imaging procedures were compared with pathol ogical data of resected pancreas to evaluate their performances. Resul ts. - The most frequent symptom was acute pancreatitis (37%). The onse t of symptoms preceded the diagnosis by 2.5 years. Diabetes mellitus a nd diarrhea were respectively detected in 33 and 23% of the cases. The combination of CT scan, endoscopic retrograde cholangiopancreatograph y and endosonography allowed correct diagnosis of intraductal papillar y-mucinous tumor of the pancreas in 100% of the cases. Tumor extent co uld be accurately determined considering the location of cystic dilata tion of the pancreatic ducts, the presence of intraductal material or parietal irregularity Actuarial 2-year survival rate was 43% in patien ts with malignant tumors. Radiological factors predicting malignancy w ere : vascular invasion, common bile duct dilatation, stricture of the main pancreatic duct and the presence of solid component in the tumor . Conclusion. - The combination of CT scan, ERCP and endosonography pr ovide accurate diagnosis of intraductal papillary-mucinous tumor of th e pancreas as well as assessment of tumor extent and malignancy.